The Harvey-Bradshaw Index Adapted to a Mobile Application Compared with In-Clinic Assessment: The MediCrohn Study
Echarri Piudo, Ana; Vera, Isabel; Ollero Pena, Virginia; Arajol, Claudia; Riestra, Sabino; Robledo, Pilar; Calvo, Marta; Gallego, Franscisco; Ceballos, Daniel; Castro, Beatriz; Aguas, Mariam; García-López, Santiago; Marín-Jiménez, Ignacio; Chaparro, María; Mesonero, Paco; Guerra, Iván; Guardiola, Jordi; Nos, Pilar; Muñiz García, Javier
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Identificadores
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Fecha de publicación
2020Título de revista
TELEMEDICINE JOURNAL AND E-HEALTH
Tipo de contenido
Journal Article
DeCS
anciano | estudios prospectivos | mediana edad | enfermedad de Crohn | humanos | adulto | índice de gravedad de la enfermedad | telemedicinaMeSH
Telemedicine | Adult | Middle Aged | Humans | Crohn Disease | Prospective Studies | Severity of Illness Index | AgedResumen
Objectives: Mobile apps are useful tools in e-health and self-management strategies in disease monitoring. We evaluated the Harvey-Bradshaw index (HBI) mobile app self-administered by the patient to see if its results agreed with HBI in-clinic assessed by a physician. Methods: Patients were enrolled in a 4-month prospective study with clinical assessments at months 1 and 4. Patients completed mobile app HBI and within 48 h, HBI was performed by a physician (gold standard). HBI scores characterized Crohn's disease (CD) as remission <5 or active >/=5. We determined agreement per item and total HBI score and intraclass correlation coefficients (ICCs). Bland-Altman plot was performed. HBI changes in disease activity from month 1 to month 4 were determined. Results: A total of 219 patients were enrolled. All scheduled assessments (385 pairs of the HBI questionnaire) showed a high percentage of agreement for remission/activity (92.4%, kappa = 0.796), positive predictive value (PPV) for remission of 98.2%, and negative predictive value of 76.7%. High agreement was also found at month 1 (93.15%, kappa = 0.82) and month 4 (91.5%, kappa = 0.75). Bland-Altman plot was more uniform when the HBI mean values were <5 (remission). ICC values were 0.82, 0.897, and 0.879 in all scheduled assessments, 1 and 4 months, respectively. Conclusions: We found a high percentage of agreement between patients' self-administered mobile app HBI and in-clinic physician assessment to detect CD activity with a remarkably high PPV for remission. The mobile app HBI might allow a strict control of inflammation by remote monitoring and flexible follow-up of CD patients. Reduction of sanitary costs could be possible.
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